Sustainable and Healthy Diets Supplement

Food and Nutrition Bulletin

2020, Vol. 41(2S) S59-S73
ª The Author(s) 2020
Sociocultural Influences on Article reuse guidelines:
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Food Choices and Implications DOI: 10.1177/0379572120975874
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for Sustainable Healthy Diets

Eva C. Monterrosa, PhD1 , Edward A. Frongillo, PhD2 ,

Adam Drewnowski, PhD3, Saskia de Pee, PhD4,5,
and Stefanie Vandevijvere, PhD6

Abstract
Background: The global policy discourse on sustainability and health has called for dietary trans-
formations that require diverse, concerted actions from governments and institutions. In this article,
we highlight the need to examine sociocultural influences on food practices as precursors to food
policy decisions.
Discussion: Sociocultural food practices relate to ideas and materials that give rise to food choices
and food patterns of a group. We begin with a discussion of how individuals experience, interpret,
negotiate, and symbolize the food world around them. We examine primarily the ideational pathways,
such as identity, gender, religion, and cultural prohibitions, and their influence on food practices. We
then provide guiding questions, frameworks, and a brief overview of food choice values to support
policy planning and design. Lastly, we explore how sociocultural change for sustainable or healthy diets
is already happening through food movements, food lifestyles, and traditional diets.

Keywords
food culture, sociocultural analysis, policy planning, policy design, food symbolism, food choice values,
sustainable healthy diets

Introduction
The current global food policy discourse on sus-
tainability and health views healthy diets as key 1
The Global Alliance for Improved Nutrition, Geneva,
for preventing malnutrition in all its forms.1 Indi- Switzerland
2
vidual food choices that result in dietary patterns University of South Carolina, Columbia, SC, USA
3
University of Washington, Seattle, WA, USA
are considered important for achieving sustain- 4
UN World Food Programme, Rome, Italy
ability targets.2 Scientists are calling for dietary 5
Tufts University, Boston, MA, USA
transformations, urging diverse, coherent actions 6
Scientific Institute of Public Health (Sciensano), Brussels,
from governments and institutions.3 Belgium
From a policy perspective, orchestrating diet-
Corresponding Author:
ary change requires considerable effort. While Eva C. Monterrosa, The Global Alliance for Improved
large dietary transformations have happened, Nutrition, Rue de Varembe 7, 1202 Geneva, Switzerland.
they have occurred alongside dramatic shifts in Email: emonterrosa@gainhealth.org
S60
livelihood, food production, and distribution. In
Latin America, for example, rapid economic
development that led to changes in urbanization,
livelihoods, and food systems was accompanied
by the “nutrition transition” (ie, significant shift
from plant-based diets to diets with a higher pro-
portion of energy from animal-source foods,
more vegetable oils and fats, and more added
sugars4). More often, dietary change has been
slower, more subtle, and dependent on sociocul-
tural food practices.5 This article highlights the
sociocultural influences on food choices and the
importance of analysis of cultural food practices
in the shaping of desirable and effective policy
actions.
Cultural Food Practices
Cultural food practices refer to material and idea-
tional (cognitive) elements that give rise to spe-
cific dietary patterns within a geographic region
or social group.6 Material elements include food
production systems that grow, transport, and dis-
tribute food; financial resources to acquire food;
and meal preparation (acquisition, cooking, stor-
age) and eating location. Ideational aspects
include cuisine, “rules” for meals, the ritualistic
uses of foods, prestige and status attributed to
foods, and social organization (roles, status)
around food production, preparation, and con-
sumption.6 In this article, we focus on ideational
aspects of culture as an entry point to shifting
norms on how we grow, procure, and prepare our
foods.
Food practices are learned mainly through
transmission from parents to children. The struc-
ture and timing of meals, where food can be con-
sumed (at table, with others, etc), and how to eat
(eg, food manners, eating pleasure) are learned
from social groups (eg, families, schools, and
peers). The learning process is both explicit, such
as verbal communication about what to eat and
exposure to information,7 and implicit, such as in
daily routines structured for children8 and in
modeling of food behaviour.9,10 Cuisine (food
combinations, flavors, and seasonings) is a
major influence in food acceptance11,12 and helps
shape food preferences among children. 13,14
Experiences that shape learning also transmit
Food and Nutrition Bulletin 41(2S)
information about values and attitudes for food
and eating.15 This transmission is partly respon-
sible for the relative stability of food practices
over time.5 Cultural food practices change in the
process of acculturation when immigrants are
exposed to new foods and to different culinary
and food acquisition practices.16
Personal System of Food Choice
The personal food system is important in under-
standing the many factors that influence food
choice at the individual level and the role of cul-
ture in driving those choices. Food choice is about
why people eat the foods they do, and decisions
about food are the outcome of processes that are
complex, influenced by biological, psychologi-
cal, economic, social, cultural, physical, and
political factors. Food choice behaviors are con-
nected to social and economic expression of iden-
tities, preferences, and cultural meanings and are
an important determinant of nutritional status and
health.
Decisions about individual food choice
involve multiple behaviors including acquiring,
preparing, storing, giving away, serving, eating,
and cleaning up. 17 These complex decisions
involve many considerations about what to eat
and when, where, and with whom to engage in
food behavior. Decisions are dynamic in both
historical time and within an individual’s life
course in both short- and long-term time frames.
There are 3 dominant perspectives for analyz-
ing food choice.17 The rationalist perspective
assumes that individuals make decisions to max-
imize benefits and minimize costs. The structur-
alist perspective assumes that social institutions
and environmental factors determine (ie,
enhance or constrain) decisions of individuals.
The constructionist perspective assumes that in
the process of decision-making, individuals
experience, define, interpret, negotiate, manage,
and symbolize the world around them. In this
section, we use a structuralist perspective to
understand the determinants of individual food
choice and a constructionist perspective to
understand the processes through which food
choice occurs.17
 Monterrosa et al

Figure 1. Social and environmental influences at multiple levels on food choice and diet-related behaviors.18
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Determinants of Individual Food Choice
The determinants of food choice can be repre-
sented through a multilevel socioecological
framework with concentric circles (Figure 1).18
These multilevel determinants interact to influ-
ence food-related attitudes and beliefs. Interac-
tions of the individual with the social and
physical environment influence food choices and
dietary behaviors.
At the inner-most circle, our food choices are
influenced by biology. The basic tastes (sweet,
sour, salty, bitter, and umami) and olfaction con-
tribute to the overall perception of food flavor,
and these are influenced by genes, physiology,
and metabolism. Some foods elicit strong sensory
pleasure responses. The oral sensation of fat is
highly rewarding, especially in the presence of
sugar,19 and the combination of sugar and fat is
linked to the stimulation of pleasure receptors in
the brain.20 The food industry has been criticized
for creating sweet, salty, and high-fat foods with
the intent of capitalizing on innate biological pre-
dispositions.21 The seeking of sweet and energy-
dense foods may have had adaptive value when
food was scarce or uncertain. The biological
mechanisms that regulate food intake may not
be a match for the current food supply that pro-
vides low-cost palatable energy-dense foods with
high reward potential and limited nutritional
value. The biological factors that control food
intake can be tempered by learning, experience,
or be altered through disease states. The second
circle deals with interactions between the individ-
ual and their food choices and relates to familiar-
ity and learned safety, conditioned food
preferences,22 and conditioned satiety.23
The specific foods that people like and their
patterns of food acceptance are largely learned
through physiological conditioning acquired
through experience of exposure to foods.22,24
New foods gain preference through repeated
exposure.25,26 Feelings of satiety are also modi-
fied through physiological conditioning and emo-
tional responses to the social context in which
eating occurs. Parents substantially shape the
context in which children encounter food by pro-
viding, modeling, encouraging, restricting, and
rewarding with food.24,27
Food and Nutrition Bulletin 41(2S)
In the third circle are the intrapersonal deter-
minants (eg, attitudes, beliefs, motivations and
values, personal meanings, knowledge and
skills),18 social and cultural norms, and interper-
sonal determinants (eg, family and social net-
works). Attitudes, beliefs, motivations and
values, and knowledge and skills develop as indi-
viduals move through their life course and
become exposed to social and cultural norms.
These determinants have influence on the foods
that individuals acquire and prepare for consump-
tion. Individuals assume identities related to food
which in turn influence food choice.28 Family and
social networks also determine food choice
through observations of what others choose,
negotiation with others with whom food is shared,
and support or lack of support from others in
making desired food choices.
The fourth circle brings in broader environ-
mental and societal influences of food choices,
many relating to the food supply, marketing, and
societal food and nutrition policies and programs.
The social and environmental (economic, infor-
mational, culture, physical) determinants noted
by Contento18 is described as “context” in the
food choice process model.17
How Food Choice Occurs
One way to understand how food choices occur is
through the perspective of the life course.17 Life
course refers to the prior events and experiences
of individuals and involves multiple trajectories,
transitions or turning points, and context. The life
course is the backdrop from which current influ-
ences on food choice occur.17
The biology, intrapersonal factors, and the
social and environmental factors (economic,
informational, culture, physical) all influence
choice in complex ways. For example, ideals
formed through personal attitudes and beliefs and
cultural norms that provide individuals with
references to evaluate food behaviors. The role
of biology and intrapersonal factors might give
rise to personal identities that individuals develop
over time and through which they act. Personal
resources, such as income, skills, relationships,
may be used to select certain foods and food pat-
terns over others. For example, a lack of time may
Monterrosa et al
dictate a preference for more convenience foods
or not knowing how to cook might influence a
pattern of eating out.
Resources are the many types of assets that are
weighed when making food choice. Assets
include income and wealth, lack of cooking
equipment and space to cook, appropriate skills
and knowledge, relationships and networks, and
values and traditions. Some resources may
enhance food choices, for example, income to
provide access to foods. Others may constrain
food choices, for example, lack of time dictating
convenience foods, and force trade-offs among
different resources. Social systems are the set of
relationships of individuals in which individuals
encounter food with others; choices are made
considering values and interests among them.
Food choice, at the individual level, occurs
within the personal food systems as cognitive
processes guiding their food behaviors in set-
tings.17 Central to personal food systems are food
choice values (eg, taste, cost, health, conveni-
ence, relationships), along with the meanings and
feelings that are associated with those values.
Food choice values vary among individuals and
over the life course. Negotiations among food
choice values are essential to sort out which val-
ues are most important to satisfy. Negotiations
may be subconscious, automatic, or less deliber-
ate. In general, however, the negotiation process
is largely conscious, often among values of an
individual, but also can be among values of mul-
tiple individuals (eg, who are in a family).
Linking cognitive evaluation of food choice
and behavior are food choice strategies.17 Strate-
gies are simplified rules used by individuals to
convert food choice values to behaviors. Strate-
gies expedite food choice by acting as a guide.
Strategies that serve well become carefully con-
structed over time into routines which make food
choice predictable and comfortable while
accounting for other life demands.29
Ideational Aspects of Food
Practices
Ideational aspects relate to symbols, meaning,
and value given to food. Foods might even be
akin to language. 30 Ideational aspects are
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expressed primarily through the social organiza-
tion (roles, status) around food production, pre-
paration, and consumption, 6 as well as the
prestige attributed to foods and ritualistic uses
of foods. In this section, we examine the domi-
nant pathways in which ideational aspects influ-
ence food practices, in alignment with the
intrapersonal, interpersonal, and social–cultural
determinants in Figure 1.
Pathway 1: Identity and Food
Food practices communicate “who we are” in
several ways. Food can be a symbol of personal
identity, group affiliation,28 and cultural iden-
tity.31 Adolescents, for example, may use “junk
food” to signal belonging to a peer group, while
healthy foods signal family.32,33 Food gifts and
food sharing are important forms to express social
belonging.5 Foods communicate a way of life. In
livelihoods centered on food production, food
holds deep significance compared to a utilitarian
significance in urban societies, where food is pur-
chased rather than produced.34 Food also signals
social status. Foods consumed by the wealthy are
often associated with refinement,30,34 while low-
prestige foods are associated with food insecurity
status35 or severe food shortage.36
Pathway 2: Gender and Food
Gender expresses many of the ideational and nor-
mative aspects of food practices. Beliefs around
femininity or masculinity contribute to gendered
food selection,37 such as the strength and mascu-
linity afforded to meats.38 In Western cultures,
there are differences among the female and male
food consumption patterns. For example, women
eat less food, but also lighter meals and delicate
foods, such as vegetables and fruits.37 In patrili-
neal societies, men are given preferential treat-
ment with regard to animal-source foods, which
are prestigious.39 Women are subject to prohibi-
tions on the basis of fertility, pregnancy, or qual-
ity of breast milk.39 Compared to men, women in
rural Nepal consumed fewer prestige foods and
had lower intake of calories, beta carotene, vita-
min B2, and vitamin C.40
S64
Tasks associated with food production, acqui-
sition, preparation, cooking, and disposal are
also gender-specific, and task distribution dif-
fers by cultures. In traditional patrilineal societ-
ies, for example, the norm is that women are
unpaid homemakers, with tasks organized
within and around the home. Food caring tasks
are often bound to identities of “being a good
mother.”41 In some contexts, it may be culturally
acceptable for men to earn a wage as cooks in
restaurants, but men will not engage in any food-
related tasks at home.5 Thus, food caring tasks
can contribute to gender stereotypes. Also
women’s food tasks restrict their leisure time,
rest,42 and participation in public life. 43 For
example, in some rural communities in sub-
Saharan Africa, time spent collecting fuelwood
for cooking can range from 4 to 15 hours per
week, depending on distance traveled, and this
is often the responsibility of women, young, and
old.44 Class and income modify the gendered
nature of intrahousehold food tasks, with higher
income households using paid (female) staff to
acquire food, cook, and cleanup.
The gendered division of household labor
influences food access and control of financial
resources for food.40 When women have more
access to economic resources, they generally will
purchases more nutritious food45 and ensure a
more equitable sharing of food among women
and children.46
Pathway 3: Religion and Food
Religions help define food practices through var-
ious rules, symbols, and meanings. Fieldhouse
cites De Garine47 who notes that foods serve 6
general functions in religious practice: (1) com-
munication with God or other supernatural forces,
(2) demonstration of faith through symbolic acts
and rituals, (3) rejection of worldliness, (4)
enhancement of feelings of identity or belonging-
ness, (5) expression of separateness, and (6) rein-
forcement of ecological pragmatism. These
functions often define food proscriptions, food
acceptability, and food practices among religious
groups.
Food and Nutrition Bulletin 41(2S)
Pathway 4: Food Prohibitions
Food prohibitions exist in every culture48 for a
number of reasons, such as sympathetic magic,
transmigration of souls, religious sanctions, and
health.47 Food prohibitions may apply to individ-
uals based on their age, sex, or hierarchical posi-
tion. Some food prohibitions are associated with
menstruation, pregnancy, and lactation.47 During
pregnancy, fears of miscarriage, difficult birth-
ing, and implications for who the child might
become impose food restrictions that affect food
and nutrient intakes. Not all prohibitions are
nutritionally relevant, because the food being pro-
hibited can be substituted for another, the restric-
tion is temporary (lasting a few days or weeks), or
the social consequences for breaking the prohibi-
tion are inconsequential.
Sociocultural Influences on Sustainable
Healthy Diets
The acceptability of and desirability for sustain-
able healthy diets will be influenced by socio-
cultural factors. For example, cultural
prohibitions might exist for eggs and insects, 2
protein sources with low greenhouse gas emis-
sions. Prohibitions for eggs may arise because
eggs have commonly represented fertility and
fecundity,47 which in some contexts, are associ-
ated with fear of barrenness, lasciviousness, or
injury to the unborn child. Today, in North
America and Europe, eating insects is largely
unthinkable due to their “disgust” factor.49 The
influence of gender on sustainable healthy diets
is also relevant. Policies that encourage using
less processed food (to reduce packaging) and
more cooking at home may discriminate or fur-
ther subjugate women. Where animal-source
foods are preferentially offered to men, the
promotion of plant-based foods may further con-
done women’s inadequate access to animal-
source food. In societies with many religions,
exploring religious food practices would be rel-
evant when considering system-wide actions,
such as taxation on lamb or goat meat, symbols
of religious affiliation, with high greenhouse gas
emissions.50
 Table 1. Example Questions on Sociocultural Influences on Food Practices for Policy Planning and Design.

Sociocultural dimension Purpose in policy planning and design Examples of policy questions

Food as an expression of identity
- Social class and wealth
- Status (hierarchy)
- Group affiliation
Gender as an expression of food
access
Food as an expression of religious To understand if dietary laws
faith and belongingness
Cultural food prohibitions as an
expression between body and the
supernatural
To understand which groups are
more likely to consider
sustainable healthy diets as
(in)appropriate or as
(un)desirable
To understand if a policy action
reinforces gender stereotypes,
discriminates women, or changes How will policies affect food access and eating norms between men and women?
food norms between men and
women
(prescriptions and proscriptions)
limit or encourage a sustainable
healthy diet
To understand if a policy further
condones prohibitions among
women, children, and adolescent How long does food prohibition last and what impact will it have on food access and
girls
What groups identify with specific foods in sustainable healthy diets? Within these
groups, are there food symbolisms that might be used to construct a narrative
and compelling story for the promotion of sustainable healthy diets?
Are there foods synonymous with cultural identity (ie, tortilla in Mexico and Central
America). How might this symbol, and what it represents, be used to position and
promote sustainable healthy diets?
What are linkages among foods in sustainable healthy diets, food choice values, and
broader values?
Will policies to promote sustainable healthy diets increase female food care tasks
and subsequently reduce leisure time and participation in civic life?
- Will the policy discourage nutrient-rich foods eaten primarily by women? Eg,
Milk and yogurt in Western societies.
- Will restrictions on animal-source foods disproportionately affect access to
meat and milk for women in low- and middle-income countries?
How might policies intensify identities of “good mothering” at the expense of “good
caregiving” (gender neutral)?
Will a policy directly affect foods that align with expressions of faith? For example,
consider lamb (with a high green-house gas emission) among the Jewish and
Muslim religions.
Are there dietary laws that restrict consumption of animal-source foods for
pregnancy, early childhood, adolescence? Will a policy for a plant-based diet
further restrict access to animal-source foods during these critical growth
periods, among vulnerable populations?
What are food prohibitions among women and children? What are the beliefs
underlying the food prohibition and what are social consequences for breaking it?
nutrient intakes?

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S66 Food and Nutrition Bulletin 41(2S)

Table 2. Passim and Bennett’s Classification for Food Among Subgroups and for the Evolution of Food
Practices.56

Category
of foods Definition Ability to change

Core Universal use, regular and consistent in the form Changes in this category happen slowly, because
of use. Staple foods are in this category core foods are foundational to eating practices,
such that if the food is missing, a meal is
incomplete
Secondary Widely used but not universal, can be variable in Ability to modify foods in this category is higher
core its use (frequency) and form. Foods prepared than in the core category. Usually foods in this
for special events are in this category category are less emotionally important than
core foods
Periphery Foods in this category are consumed infrequently Category with greatest ease and fluidity for
and are often characteristics of individuals and change
not of subgroups

Sociocultural Influences of Food preparation, and consumption of food. These data

Practices and Policy Planning and
Design
Having summarized the individual and sociocul-
tural influences on food practices, we now exam-
ine the frameworks and concepts that may assist
in policy planning and design. It is extremely
important to include experts in anthropology and
sociology so that pertinent questions are posed—
see list of guiding questions in Table 1—and use-
ful inquiry and analytical frameworks are
selected. The sociocultural analysis should be
conducted at the group level (not at the country
level), because there is significant variation
among and within social groups with regard to
the ideational aspects of culture, which often
results from situational factors.51 Sociocultural
analysis permits exploration of this diversity to
avoid stereotypical inferences and unintended
consequences.
The biocultural framework52 is an inquiry
framework that examines the production, distri-
bution, acquisition, preparation, and consumption
of food. It explores the physical and natural
resources for food production; social systems that
facilitate the import or export of food; social
organization of households, social institutions,
and political and economic structures; and tech-
nologies needed for food production, processing,
and preparation. It explores beliefs and values
that affect and relate to the acquisition,
are collected through in-depth research, such as in
focused ethnographic studies.53-55
The Passim and Bennett’s classification is a
descriptive framework useful for examining diet-
ary practices at group level.56 This classification
draws on food use and frequency of consumption
(Table 2). In this framework, core foods are staple
foods, which are used by most of the population
(eg, rice in Philippines, tortilla in Mexico, bread
in the Netherlands). The secondary core includes
widely (but not universally) used foods such as
fruits and vegetables, dairy products, and their
various preparations, such as instant, ready-to-
eat, or frozen, and use forms (meals, snacks, etc).
Secondary core foods also include foods prepared
for special events (ie, weekly family gatherings,
festivals). The periphery category foods are rarely
used, or used by a small subgroup of the popula-
tion, such as very modern food innovations (eg,
probiotic drink), expensive and prestigious foods,
or food “cravings” of pregnant women. The Pas-
sim and Bennett classification is useful for policy
planning and design because it identifies food
categories that are amenable to dietary change.
Over time, the classification of foods evolves
due to lower food prices, improvements in food
storage and cooking technologies, and marketing
of specific foods, so the Passim and Bennet
framework is a useful tracking tool for the evolu-
tion of food practices. Countries that already col-
lect food frequency, 24-hour recall, or dietary
Monterrosa et al S67

Table 3. A List of Selected Food Choice Values From the Published Literature.

Values Descriptiona

Naturalness Minimal processing, fresh foods

Taste (sensory appeal) Taste, smell, texture, flavor, and other sensorial aspects
Appearance Attributes of food that make food appealing (eg, consistency of food, its color,
presentation on plate)
Cost or affordability Cost refers to price per reference amount. Affordability refers to cost per income or
relative to other expenses
Comfort Feelings (eg, happiness) experienced by eating the food
Convenience Time saving in preparation, cooking, or cleaning
Physical availability Distance that the consumer travelled to obtain food
Tradition (food Traditional cuisines, foodways, food customs
symbolism)
Managing social Achieving harmony, accommodating preferences, managing conflicts
relationships
Nutrition (Health) Macro and micronutrients, trace elements, electrolytes, fiber, phytochemicals,
antioxidants. Health-promoting or health-giving attributes of food
Safety Not causing illness; free of chemical or microbial contamination and other hazards
Variety Incorporation of multiple food groups into the diet (as defined by nutritionists). Another
form of variety is the method of cooking the food (eg, boiling, frying, roasting)
Environmental impact Land, water, energy used in producing or preparing food. Food loss and waste
Origin Food provenance (eg, food miles, place of production)
Fairness (ethics) All actors involved in food production benefit equally
a
Descriptions as stated in the literature; these are not standard definitions.

record data through surveys can apply the Passim
and Bennett classification for an examination of
core, secondary core, and periphery foods by dif-
ferent population subgroups and regions.
Values and Food Choice Values and Their
Relevance to Food Practices
The ideational elements of culture, such as sym-
bols, ideas, and meanings, are often expressed
in values. We draw on the anthropological (eva-
luations of our mode of conduct)57 and psycholo-
gical (beliefs about an end state of existence)58
definitions of values.
Values help negotiate food choices and/or sim-
plify choices. Lewin59 argues that a system of
values is the foundation that influences decisions
on food and bring about conflicts of varying
intensities. Values are linked with feelings and
emotions.60 Cultural values are the shared ideals
of what is good and desirable for a group, and
these values are the basis for behavior norms.61
For both individuals and societies, there is a
hierarchy of the relative importance of values,
and the relative importance changes over
time.58,61
In the food choice literature,62-65 the “food
choice value” label captures diverse ideas (see
Table 3), from a food attribute (taste, appearance,
naturalness), to food procurement (availability,
cost), and food preparation and eating (variety,
convenience). Other food choice values refer to
an end state (safety and healthfulness), modes of
conduct (managing social relationships, fairness),
or the material world (origin, environmental
impact). Because we use values to negotiate food
choices,17 it is important to determine how food
choice values are linked to food symbols, mean-
ings, and behaviors.
Concluding the extent to which food choice
values determine food choice is difficult because
of 2 methodological challenges. The first relates
to defining values and the purpose they serve in
food choice. There are multiple definitions of the
term “value”; sometimes values are confounded
with attitudes, motives, or needs. Authors may
not distinguish between instrumental and
S68
terminal food choice values, with the former as
means to an end and the latter as a desirable end
state (eg, ethical consumption).58 Because many
personal food choice values are continuously
negotiated,17 they are probably used to achieve
an end.63
The second challenge relates to establishing
attribution in the links between food choice val-
ues and behavior. The prevailing notion in deci-
sion theory is that deliberative and automatic
process drive choice.66 Many (food) decisions are
automatic or subconscious,67 intuitively under-
stood,68,69 or embedded in food routines and
habits.29 Food choice values, on the other hand,
are a cognitive concept which can be articulated,
and food choice values are used in deliberative
decision-making.29 In automatic decision con-
texts, 68 a food choice value (often measured
through survey and self-reports70) may reflect a
choice justification rather than choice predic-
tion,66 so it is difficult to assign causal attribution
of a food choice value to a food-related intention
or behavior.68
Nevertheless, analysis of values is useful for
policy planning and design. The utility of values
lies in their ability to capture culturally relevant
ideas, meanings, emotions, and beliefs and thus
can be used to drive intentions58 and to change
norms and encourage new lifestyles (modes of
existence).71 When food choice values align with
personal or cultural values, we find associations
with food purchase intentions, for example, with
organic foods in Europe,72 meat choices among
Dutch consumers,73 and environmentally friendly
consumption behaviors among the Danish.74 Val-
ues may help create stories, myths, and narratives
because values capture deep, universal truths.75
Emotions and forging emotional connections are
indispensable for creating promotional cam-
paigns that motivate consumers toward health
and sustainability.76,77
Promoting Sociocultural Change in
Food Practices
Sociocultural change for sustainable or healthy
diets is already happening through food move-
ments, food lifestyles, and traditional cuisines.
Food movements are built on multiple values that
Food and Nutrition Bulletin 41(2S)
address how to grow, transport, source or buy,
and cook foods. Some values encompass ethical,
moral reasons, which create a strong emotional
connection with consumers.78 Movements thrive
by fostering collective identities and building
shared emotional experiences.79
In Western countries, progressive food move-
ments aim to support sustainable healthy diets.
The “slow food movement” seeks a consumer
class that selects food based on health, sustain-
able livelihoods, and respect for the environ-
ment.80 This movement uses multiple values,
such as sensory pleasure, naturalness, origin, fair-
ness, and environmental impact. Variations of
this movement are “locavores” or “naturalistic
foodways” that support local, sustainable agricul-
ture and unprocessed foods.81 The organic food
movement centers on nonchemical production of
crops and livestock.82 Organic food and “slow
food” movements may or may not promote policy
change.82 Progressive movements are often criti-
cized as elitist.
Radical food movements, built on moral orien-
tations (what we ought to do), are “food justice”
or “food sovereignty.” In Western countries,
“food justice” addresses class and racial inequi-
ties.83 In the global south, “food sovereignty”
eschews dominant neoliberalism to food produc-
tion, being based on principles of human rights,
sustainable agrarian livelihoods, local agroecol-
ogy, and knowledge.84 Food production is driven
by needs and aspirations of local people (rather
than the market or corporations) for healthy and
culturally appropriate foods.85
Food lifestyle is a system of cognitive cate-
gories (beliefs/attitudes) that link a set of goods
(eg, food) to a set of values, and lifestyles are
enduring dispositions of behavior.86,87 For exam-
ple, veganism eschews exploitation of animals for
food, clothing, medicines, testing of drugs, or
additives.88 Lifestyles, such as veganism and
vegetarianism, are also bound to social89 and reli-
gious identity.
The return to traditional cuisines values how
food is produced, creating emotional linkages
with the cuisine of the past.90 The new food-
based dietary guidelines of some Latin America
are redefining “traditional cuisine” not only as
traditional recipes and meals but also consuming
Monterrosa et al
minimally processed foods. The Brazilian food-
based dietary guidelines, for example, recom-
mends consuming natural or minimally process
foods and eating in accordance with Brazilian
food culture.91 A similar frame is evoked in the
Uruguayan food-based dietary guidelines. In con-
trast to traditional cuisines, Indigenous people’s
diets explicitly link food, health, environment
(biodiversity, land use), and cultural identity
(rites, traditions).92
A critical question is whether traditional ways
of eating are associated with both better health
and lower environmental footprints. In HIC, there
is evidence on positive health and environmental
impacts for the Mediterranean93 and New Nordic
diet.94 Among Canadian Artic Indigenous Peo-
ples, meats and fish, native to the Artic, support
daily intakes of vitamins (B6, A, C, D, E, ribo-
flavin) and minerals (iron, zinc, selenium, among
others) for adults and children.95 In other con-
texts, however, the relationship between health
and environmental footprint may be more com-
plex. For example, agropastoralist in Kenya, who
depend on milk and meat from goats, camel, or
cattle, have better nutrient intakes of vitamin A
and B12,96 but families who shift to plant-based
diets show an increase in the risk of anemia
among children.97
Conclusions
Policy planning and design to determine what
actions could be taken to promote sustainable
healthy diets should include a sociocultural anal-
ysis to understand the acceptability and desirabil-
ity of any policy action. Individual choices are
influenced by the broader sociocultural context,
where in the process of decision-making individ-
uals experience, define, interpret, negotiate, man-
age, and symbolize the world around them. The
ideas, symbols, and meanings associated with
foods are part of our shared sociocultural context.
Values are another way to link the individual and
sociocultural level. Food movements, food life-
styles, and traditional diets are examples of how
values, symbols, and ideas can be leveraged for
collective action, for alternative ways to grow,
procure, and consume foods. Businesses and civil
society organizations can support and mobilize
S69
consumers toward more ethical and citizen-
oriented food actions.
An analysis of the sociocultural influences on
food practices is needed so that food policy fully
aligns with society and culture. This can be
achieved by using the frameworks and concepts
we discussed, along with empirical data collected
through in-depth qualitative methods and sur-
veys. For example, an ethnographic module could
be applied to a subsample of dietary survey par-
ticipants. This tool will be useful not only for
identifying symbols, meanings, and values but
also for examining food practices and its associa-
tions with the ideational aspect of culture. Policy
makers should rely on local or international tech-
nical experts and agencies to facilitate the con-
vergence of feasible methods and carry them out.
Global normative agencies should advocate for
sociocultural analysis to assess the acceptability
and desirability for sustainable healthy diets.
Acknowledgments
E.A.F. drafted the section personal food system and
food choice. E.M. drafted all other sections of the
manuscript. All authors contributed to the conceptua-
lization of the paper, revisions, and reviewed and
approved the final draft of the manuscript. A version
of this paper was presented at the International Con-
sultation on Sustainable and Healthy Diets, FAO head-
quarters, Rome, Italy, July 1-3, 2019. All authors
received a stipend from FAO for this paper.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest
with respect to the research, authorship, and/or publi-
cation of this article.
Funding
The author(s) disclosed receipt of the following
financial support for the research, authorship, and/or
publication of this article: This paper was made poss-
ible with funding from FAO.
ORCID iDs
Eva C. Monterrosa https://orcid.org/0000-0003-
1665-0756
Edward A. Frongillo https://orcid.org/0000-0002-
8265-9815
S70
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